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Narrative

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Source1

{
  "resourceType": "CarePlan",
  "id": "care-plan-cvd-screening-example",
  "meta": {
    "profile": [
      "https://hl7.lt/fhir/cvd/StructureDefinition/care-plan-lt-cvd"
    ]
  },
  "language": "en",
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "contained": [
    {
      "resourceType": "Goal",
      "id": "goal-ldl",
      "lifecycleStatus": "active",
      "description": {
        "text": "Target LDL Cholesterol, considering the cardiovascular disease risk group"
      },
      "subject": {
        "reference": "Patient/patient-male-example"
      },
      "target": [
        {
          "measure": {
            "coding": [
              {
                "system": "http://loinc.org",
                "code": "13457-7",
                "display": "Cholesterol in LDL [Mass/volume] in Serum or Plasma by calculation"
              }
            ]
          },
          "detailQuantity": {
            "value": 1.4,
            "unit": "mmol/L",
            "system": "http://unitsofmeasure.org",
            "code": "mmol/L"
          },
          "dueDate": "2026-10-31"
        }
      ]
    },
    {
      "resourceType": "Goal",
      "id": "goal-bmi",
      "lifecycleStatus": "active",
      "description": {
        "text": "Target Body Mass Index (BMI) of 22.5 kg/m2"
      },
      "subject": {
        "reference": "Patient/patient-male-example"
      },
      "target": [
        {
          "measure": {
            "coding": [
              {
                "system": "http://loinc.org",
                "code": "39156-5",
                "display": "Body mass index (BMI) [Ratio]"
              }
            ]
          },
          "detailQuantity": {
            "value": 22.5,
            "unit": "kg/m2",
            "system": "http://unitsofmeasure.org",
            "code": "kg/m2"
          }
        }
      ]
    },
    {
      "resourceType": "Goal",
      "id": "goal-bp",
      "lifecycleStatus": "planned",
      "description": {
        "text": "Target BP 120-129/<80 mmHg"
      },
      "subject": {
        "reference": "Patient/patient-male-example"
      }
    }
  ],
  "extension": [
    {
      "url": "https://hl7.lt/fhir/cvd/StructureDefinition/risk-group-ext-lt-cvd",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "https://tx.hl7.lt/fhir/CodeSystem/risk-group",
            "code": "very-large",
            "display": "Very large"
          }
        ]
      }
    }
  ],
  "status": "active",
  "intent": "plan",
  "title": "Plan for Heart and Blood Vessel Disease Screening Measures",
  "description": "Comprehensive plan detailing lifestyle modifications, pharmacological advice, and biometric targets for CVD risk reduction.",
  "subject": {
    "reference": "Patient/patient-male-example"
  },
  "created": "2025-10-31T10:00:00+02:00",
  "supportingInfo": [
    {
      "display": "A healthy weight is when Body Mass Index (BMI) is 18.5-24.9 kg/m2."
    },
    {
      "display": "Regular use of prescribed medication: Antilipid treatment, Antihypertensive and heart rate regulating (cardioprotective) treatment, Currently used medications."
    }
  ],
  "goal": [
    {
      "reference": "#goal-ldl"
    },
    {
      "reference": "#goal-bmi"
    },
    {
      "reference": "#goal-bp"
    }
  ],
  "activity": [
    {
      "performedActivity": [
        {
          "concept": {
            "coding": [
              {
                "system": "http://snomed.info/sct",
                "code": "702388001",
                "display": "Tobacco use cessation education (procedure)"
              }
            ]
          }
        }
      ],
      "progress": [
        {
          "text": "Quitting smoking intervention selected: Pharmacological and Behavior change tools."
        }
      ]
    },
    {
      "performedActivity": [
        {
          "concept": {
            "coding": [
              {
                "system": "http://snomed.info/sct",
                "code": "11816003",
                "display": "Diet education (procedure)"
              }
            ]
          }
        }
      ],
      "progress": [
        {
          "text": "Healthy Nutrition Plan: Diet should include consumption of fruits and vegetables > 200 g/day, 35–45 g of fiber (recommended from grains), moderate consumption of nuts (30 g/day, unsalted), 1–2 servings of fish per week (one fatty fish), limited amounts of lean meat, low-fat dairy products, and liquid vegetable oils.\nSaturated fats <10% of total fat intake, replacing them with polyunsaturated fats, reducing trans fats, preferably not from processed foods and making up <1% of total energy intake.\nSalt ˂ 5–6 g per day.\nAvoid alcohol if consumed, limit intake to ˂100 g per week or <15 g per day. Avoid high-energy foods, such as sugar-sweetened soft drinks."
        },
        {
          "text": "Focus on reducing processed sugar intake dramatically by eliminating soft drinks."
        }
      ]
    },
    {
      "performedActivity": [
        {
          "concept": {
            "coding": [
              {
                "system": "http://snomed.info/sct",
                "code": "1287704009",
                "display": "Physical activity consultation (procedure)"
              }
            ]
          }
        }
      ],
      "progress": [
        {
          "text": "30-60 minutes of moderate physical activity daily, beneficial and irregular physical activity."
        },
        {
          "text": "Focus on 3 sessions of swimming per week in addition to daily walks."
        }
      ]
    },
    {
      "performedActivity": [
        {
          "concept": {
            "text": "Antilipid treatment prescribed by the doctor."
          }
        }
      ],
      "progress": [
        {
          "text": "Atorvastatin 20mg daily."
        }
      ]
    }
  ],
  "note": [
    {
      "text": "Recommend follow-up appointment with a cardiologist in three months to review treatment efficacy and progress toward goals."
    }
  ]
}